R
eflection on the roots of clinical psychology
can promote a better understanding of thefield. This chapter provides a view of both the his-
torical sweep of clinical psychology and some of the
current issues that confront the field.
Historical Roots
Establishing a certain time period or designating
a particular person as the beginning of clinical
psychology can be arbitrary if not downright
misleading. One can certainly go back to Greek
philosophers such as Thales, Hippocrates, or
Aristotle who, long ago, were speculating about
human beings and the nature of thought, sensation,
and pathology (Shaffer & Lazarus, 1952). Because
these philosophers are cited as antecedents of nearly
every profession, movement, or system of thought
in Western society, their citation here does little,
perhaps, except to affirm the honorable beginnings
of clinical psychology.
For the years prior to 1890, there is really very
little in the history of clinical psychology to separate
it from the history of abnormal psychology or, as
Zilboorg and Henry (1941) termed it, “medical
psychology.”Reisman (1976) finds it more useful
to search for the roots of modern clinical psychology
in the reform movements of the 19th century, which
ultimately resulted in improved care for the mentally
ill. Such improvements, and the humanitarian values
of those who encouraged them, fostered the faint
beginnings of the mental health professions as we
know them today (Hothersall, 1984). One of the
major figures in this movement was Philippe Pinel,
a French physician. Shocked by the senseless brutal-
ity that was the custom in 19th-century“mental
hospitals,” he managed to get himself appointed
head of the asylum at Bicêtre and, later, Salpêtrière.
Through kindness and humanity, he accomplished
much in a very difficult field. Whether Pinel’s
accomplishments should be regarded as personal
achievements or as logical developments growing
out of the philosophy of Rousseau and the idealism
of the French Revolution is unclear. In any event,
his work was a milestone in the development of
psychiatry, the mental health approach, and ulti-
mately, of clinical psychology.
At about the same time, an Englishman,
William Tuke, was devoting himself to the estab-
lishment of what might be called a model hospital
for the humane treatment of the sick and troubled.
In America, Eli Todd was laboring long and
successfully to develop a retreat in Hartford
for the mentally ill. Like his European counter-
parts, Todd emphasized the role of civilized care,
respect, and morality. Through his efforts, it
became less fashionable to regard mental patients
as incurable. The search for psychological antece-
dents to mental illness and an emphasis on treat-
ment had begun to replace the routine harshness
of custody.
Another American who had a profound effect
on the mental health movement was Dorothea Dix
(Figure 2-1). She campaigned for better facilities for
the mentally ill. With determination and single-
mindedness, Dix pushed, prodded, and cajoled
until government officials responded. Using the
force of logic, facts, public sentiment, and good
old-fashioned lobbying, she wrought her will. In
1848, New Jersey responded by building a hospital
for the“insane”—the first in a procession of more
than 30 states to do so.
Out of the efforts of such people, the ground-
work was laid for a field of clinical psychology.
However, it would be a mistake to evaluate these
contributions apart from the social forces and ideas
of the time. In the 19th century, philosophers and
writers were proclaiming the dignity and equality of
all. Governments were beginning to respond. Even
science, which was just coming into its own, con-
tributed to the movement.
An atmosphere of“knowledge through exper-
imentation”began to prevail. A feeling that people
can predict, understand, and perhaps even control
the human condition began to replace older wis-
dom. This ferment in science, literature, politics,
government, and reform combined to produce
the first clear and unmistakable signs of new profes-
sions in what would come to be referred to as
“mental health.”HISTORICAL OVERVIEW OF CLINICAL PSYCHOLOGY 33